Wednesday, June 30, 2010

Congratulations

Prof. Datuk Dr. Tan Si Hai @ Tan Si Yen
Prince Court Medical Centre Sdn Bhd

on being confered the
PANGLIMA SETIA DI RAJA (P.S.D.)

By
Yang Di-Pertuan Agung Malaysia XIII
Seri Paduka Baginda Yang Di-Pertuan Agong
Al-Wathiqu Billah Tuanku Mizam Zainal Abidin Ibni Al-Marhum
Sultan Mahmud Al-Muktafi Billah Shah

on the occasion of His Royal Highness' Birthday
on 5th June 2010 / 22 Jamadilakhir 1431H

Best Wishes and Warmest Regards
MalaysianKidneySPA

Saturday, June 26, 2010

Psychiatric issues in renal failure......

Psychiatric issues in renal failure and dialysis

A De Sousa
Consultant Psychiatrist, Get Well Clinic, Mumbai, Maharashtra, India
Indian J Nephrol 2008;18:47-50

Abstract

This article aims to bring to the fore, issues regarding the interface of psychiatry and renal failure. Depression, anxiety, suicide and delirium are common complications observed in patients with renal failure. Pharmacological management of these problems need stringent monitoring on part of the psychiatrist. This article examines the various complications that may be observed in patients with renal failure while discussing treatment approaches and also emphasizing the need for interdisciplinary team work in improving the quality of life of patients with renal failure and those on dialysis.

Read the full article here

Monday, June 21, 2010

Hepatitis C in Dialysis Patients

Hepatitis C in Dialysis Patients


Department of Medicine, King Khalid University Hospital, Riyadh, Saudi Arabia
Saudi J Kidney Dis Transpl 2003;14:442-50

Abstract
Hepatitis C virus (HCV) infection is a major health problem in hemodialysis patients. Identified risk factors include duration on dialysis and blood transfusion. A more important risk factor contributing to the high prevalence of anti-HCV, particularly in the developing countries, could be the non-adherence to the known universal infection control precautions. The factors that might help reduce and/or prevent the spread of HCV infection among patients on dialysis include: early screening of patients for anti-HCV, reduction of the number of blood transfusions given, strict application of universal infection control precautions and isolation of patients or machines which ever feasible. The issue regarding isolation of anti­HCV positive patients is controversial and although it is not recommended by the Centers for Disease Control to isolate these patients, it may be advisable to do so, particularly in the developing countries, wherein a high prevalence of anti-HCV exists among the dialysis population.

Read the full article here

Sunday, June 20, 2010

To All
Specialists, Patients, Renal Nurses & Associates
who are fathers
wishing you
"A Happy Father's Day!"

Best Wishes & Warmest Regards
MalaysianKidneySPA

Friday, June 18, 2010

THE REAL POT OF GOLD.....

We are pleased to share a beautiful poem by Dr. Victor Tan Soo Lim taken from his book entitled "The Secret of Change"

THE REAL POT OF GOLD

Every morning, the saga unfolds:
Restless souls are awake at the cock’s crow,
Rushing out into the dark, misty cold,
Fighting heavy traffic to play their roles
In a place where their future hold,
Working passionlessly on what’s been told,
Bearing and tolerating untold woes
As part of the chase for the pot of gold
That is promised at the end of the rainbow.

Overstressed, many lives take a toll,
Existing, not living life as a whole:
Health suffers many folds,
Relationships often put on hold,
Many desired vacations, they withhold
As they continue to put a front so bold
Believing they will find their pot of gold
At the elusive end of the rainbow.

If the truth be told:
Life is not one mad rush for gold,
It is not an ostentatious personal show
To accumulate wealth till it overflows;
It is the character you mould,
It is the values you extol,
It is your selfless spirit that you grow
As you help others achieve their goals.
The true reward is not the pot of gold:
It is your heart of gold.

Wednesday, June 16, 2010

Hepatitis C virus infection.....

Hepatitis C virus infection among maintenance hemodialysis patients: A preventable problem of the world
Saudi Journal of Gastroenterology, Year 1996, Volume 2, Issue 1



Department of Medicine, Chiba University Hospital, and Sanai Memorial Clinic, Chiha, Japan

Abstract

Hepatitis C virus (HCV) infection, unrelated to blood transfusion is very common among hemodialysis patients with chronic renal failure. The positivity rate for anti-HCV varies from 18% to 91% among various countries. It is due not only to the past blood transfusions, but also to nosocomial transmission which is preventable. The main route of virus entry, is most likely, the two (arterial and venous) needle holes that are touched by the fingers of the physi­cian and the nurse repeatedly. The recommended preventive measures include: the use of a sterile glove, finger sterilization with a disinfectant solution, immediately before touching the needle/needle hole. and repeated education of the staff. Whether the anti-HCV positive patients should be separated from the negative, largely depends on the prevalence of HCV infection within the dialysis unit.

Read full article here

Saturday, June 12, 2010

Misplacement of an internal jugular hemodialysis catheter...

Misplacement of an internal jugular hemodialysis catheter due to stenosis caused by previous short-term catheterization

Prakash K Dubey
Department of Anesthesiology and Critical Care Medicine, Indira Gandhi Institute of Medical Sciences, Patna, India

Dual lumen hemodialysis catheters are usually inserted via the right internal jugular vein (IJV). Subclavian vein (SCV) is generally avoided to prevent thrombosis or narrowing. [1] The site of stenosis caused by SCV catheter is usually near the junction of the SCV and IJV. [2]

A 30-year-old female, suffering from endstage renal disease, was in the operating room for insertion of a hemodialysis catheter. She had undergone right IJV catheterization about 45 days back. The previous catheter had remained in situ for about 15 days. The exact cause of catheter removal was not documented. As she had no clinical signs or symptoms in the upper limb or the neck suggesting any complication, it was decided to cannulate the right IJV again.

After instituting monitoring with lead II electrocardiogram, noninvasive blood pressure, and a pulse oximeter, a 12.5 Fr hemodialysis catheter (Soft-cell® PC kit, Bard Access Systems, Utah, USA) was placed uneventfully via the right IJV under local anesthesia with full aseptic precautions. Free aspiration of blood via both the lumens was attained through a 5-ml syringe. A chest radiograph was obtained postprocedure and haemodialysis was started without inspecting the X-ray film. However, a satisfactory blood flow through the hemodialysis machine could not be obtained. Gentle manipulation of the catheter and change in patient position made no difference to the flow. Meanwhile, the X-ray film revealed catheter misplacement into the ipsilateral SCV [Figure 1].

Read full article here

Friday, June 11, 2010

Lighter moments....

An old man was driving on the freeway when his mobile phone rang. It was his wife..."Herman" she cried "I just heard on the news that there's a car going the wrong way on 280. Please be careful"

"Hell" exclaimed Herman..."Its not just one car. Its hundreds of them!"
Congratulations

to

Pusat Dialisis Nephrocare

No 15 & 17, Jalan BPM 14,
Taman Bukit Piatu Mutiara,
Bukit Piatu, 75150 Melaka

on the commencement of your services


Best Wishes & Warmest Regards
from
MalaysianKidneySPA

Sunday, June 6, 2010

Refusing To Continue Dialysis....

The Women Who Did Not Mean “NO”

By Michael Blumenfield, M.D

A case history
An 82 year old Italian speaking grandmother with a very dedicated and loving large family was coming to the hospital three times a week to receive hemodialysis for kidney failure. This is a four or five hour process where tubes are attached to her blood vessels through a special connection called a fistula and her blood is run through a machine with a filter system to clean it of toxins since her kidneys are not functioning properly. She was viewed as having been depressed for approximately two years and frequently would be reluctant to come for her dialysis. She was on Prozac, an antidepressant, for about one year with no apparent change.

Recent Complication
Most recently the patient’s fistula clotted and there were no more readily available sites to reconnect the equipment. Surgery was recommended to create a new vascular site for the dialysis but the patient refused to go along with this procedure. The family explained that she had suffered enough and now just wanted to stop the dialysis and peacefully pass away.

Read full article here

Friday, June 4, 2010

Defibrillation during renal dialysis

Defibrillation during renal dialysis: A survey of UK practice and procedural recommendations

By Scot Birda, Graham W. Petleyb, Charles D. Deakina & Frank Clewlowb
http://www.resuscitationjournal.com/article/S0300-9572(06)00668-X/abstract

Abstract

Introduction
Defibrillation of patients connected to medical equipment that is not defibrillation proof risks ineffective defibrillation and harm to the operator as a result of aberrant electrical pathways taken by the defibrillation current. Many renal dialysis systems are not currently defibrillation proof. Although national and international safety standards caution against defibrillating under this circumstance, it appears to be an area of confusion that we have investigated in more detail.

Methods
Thirty renal dialysis units across the UK were invited to participate in a telephone survey of current practice from 1 October 2004 to 1 October 2005. The Medical Healthcare Regulatory Agency and renal dialysis machine manufacturers were contacted for advice, and current safety standards were reviewed.

Results
Twenty-eight renal dialysis units completed the survey. Seven (25%) units would not disconnect patients from dialysis equipment during defibrillation, collectively reporting 14 patients who had required defibrillation during dialysis. Eighteen (64.3%) units would disconnect patients from dialysis equipment during defibrillation, collectively reporting 29 patients who had required defibrillation during dialysis. No complications were identified by this survey, through the MHRA or through a literature search.

Conclusion
Defibrillation of patients while undergoing renal dialysis is common practice in the UK. Although no adverse events have been reported, this practice risks injury to the patient and clinical staff, and equipment damage if the dialysis equipment is not defibrillation proof. It is in breach of national and international safety standards and should not be practiced.

Wednesday, June 2, 2010

Facial protection......

Facial protection in renal dialysis units: a literature review

By Lorraine Bublitz, Renal Society of Australasia Journal, Nov. 2005

Abstract

Aim The aim of this paper is to raise awareness and critically evaluate the need for greater facial barrier protection, in order to reduce the frequency of mucocutaneous exposure for health care workers in renal dialysis units (RDU).

Method A literature review of published literature related to the use and application of standard precautions was conducted, focusing on facial barrier protection for health care workers (HCW) in various health care settings.

Findings Despite renal dialysis nurses having considerable risk of permucosal (splash) contamination the overwhelming literature discusses this exposure in a variety of other health care settings. HCW level of compliance to standard precautions, particularly the use of personal protective equipment (PPE) requires significant improvement. There is an urgent need for PPE to be more suitable and easily accessible to the HCW in order to prevent interference with patient procedures, and promote compliance of standard precautions.

Conclusion The literature confirms that HCW in RDU are at risk of exposure to blood borne infections. HCW rarely fully implement and comply with standard precautions in regards to application of PPE in various health care settings however further research is required to determine compliance in renal dialysis units. Facial barrier protection requires significant and urgent redesign in suitability, safety and accessibility in order for HCW to fully embrace its use.

Read full article here

Haemodialysis Directory 2010

We have uploaded the latest list of Private and NGO Haemodialysis Centres by States according to the National Renal Registry 2010.